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Biomedical subjects

R Buonaguidi

Publications and source records attributed to R Buonaguidi.

At least 19 recordsLinked to original sources
PubMed1991

Results and prognostic factors of surgery in the management of non-small cell lung cancer with solitary brain metastasis.

Between 1975 and 1988, 37 patients with resectable non-small cell lung cancer (NSCLC) and synchronous (within 1 month, n = 10) or metachronous (n = 27) solitary brain metastasis (SBM) underwent combined excision of their lesions. Overall 5-year and median survival were 30% and 27 months (range, 3 to 125+ months), respectively. Twenty-seven patients had a relapse, and their median disease-free interval (DFI) was 17.5 months (range, 1 to 108 months). The most frequent (78%, n = 20) site of first recurrence locally was either the ipsilateral thorax (n = 14) or brain (n = 6). In univariate analysis, age, primary tumor and lymph node status; tumor histology, size, and side; type of pulmonary resection; side and location of SBM; and onset of presentation did not affect survival and DFI. By contrast, the interval (less than or equal to versus greater than 12 months) between the two operations significantly affected survival (P = 0.0096) and DFI (P = 0.046). The DFI was also affected by the administration of adjuvant chemotherapy (AC) for the primary tumor (P = 0.02). Using the Cox model, AC was the most independent predictor of DFI. These data support the inclusion of surgery in the therapeutic armamentarium for patients with NSCLC and SBM.

Adult↗
PubMed1988

The TSH secretion in the human pituitary adenomas.

TSH secretion by a pituitary tumor is very rare (2%) and it is often associated with another hormone: GH or PRL essentially. We present here nine tumors in which the TSH secretion was proved by immunocytochemistry (ICC) and by RIA in the tumor extracts, in the serum and in the culture medium. Four tumors secreted TSH only. Five tumors secreted TSH and GH predominantly. In 3 of them traces of other hormones (PRL and FSH) were also detected. The "pure" TSH adenomas were monomorphous with typical ultrastructural and immunocytochemical features. Plurihormonal TSH adenomas were bimorphous with different cells secreting GH and TSH or monomorphous with one type of cell which secreted TSH or GH or both TSH and GH. In a majority of the cases, the tumoral TSH secretion induced hyperthyroidism but in 2 patients with TSH adenoma there was euthyroidism and in another with TSH-GH adenoma there was no sign of acromegaly and GH serum levels were normal.

Adenoma↗
PubMed1987

Recessive cancer genes in meningiomas? An analysis of 31 cases.

Cytogenetic studies on 31 human meningiomas revealed clonal abnormalities in 14 of them. Monosomy 22 was present in three cases as the only abnormality, and in five it was associated with monosomy 18, monosomy 14, loss of X, loss of Y, and trisomy 20, respectively. We found a number of rearrangements involving chromosome #22: an i psu dic(22)(pter----q11::q11----pter) in two cases and a t(18;22)(q12;q11) in another case. Two cases showed a complex translocation involving #7 and #14: t(2;7;14)(q23;q36;q22) and t(1;7;14)(q25;q32;q22), respectively. Other clonal chromosome abnormalities were del(1p) (present in two cases); der(9)t(9;?)(q34;?); der(7)t(7;?)(q31;?); der(22)t(22;?)(q11;?); and a 9p+ chromosome. The relevance for the pathogenesis of human meningiomas of these chromosome anomalies is also discussed with reference to the previous literature. The possible involvement of recessive cancer genes present on the long arm of chromosome #22 is also discussed.

Adult↗
PubMed1985

Surgical treatment of primary lung cancer and solitary brain metastasis.

Twenty patients with carcinoma of the lung and a brain metastasis have undergone combined lung and brain surgery, which was synchronous in five. There were no operative deaths. Survival from the first surgical intervention was less than one year (3-10 months) in four patients (20%), one to two years in four (20%) and more than two years (26-66 months) in five patients (25%). Seven patients (35%) are alive and well after an average period of three years and three months (15-66 months). Actuarial survival at five years is 33.6%. All patients had severe neurological symptoms and 18 (90%) had a complete remission. Our experience and data reported in the literature point to the effectiveness of combined lung and brain surgery in prolonging symptom free survival in patients with lung cancer and solitary brain metastasis.

Adult↗
PubMed1984

[Bromocriptine therapy from the 2d month of pregnancy induces regression of neuro-ophthalmologic complications caused by macroprolactimona].

In a 32 year old woman harboring a macroprolactinoma with supra and laterosellar extension, bromocriptine was able to reduce the size of the tumor and the very high circulating levels of prolactin, restoring ovulatory menstrual cycles. At the 8th week of a not recommended pregnancy, the patient presented bitemporal superior quadrantopsia and headache. After reinstitution of bromocriptine therapy the woman showed a rapid improvement of neuroophtalmological complications. The treatment was continued till the delivery; a normal baby was born.

Adult↗
PubMed1984

[Primary empty sella syndrome. Clinical and radiological study, and evaluation of pituitary function].

Empty sella syndrome is an anatomoclinical condition in which the herniation of the chiasmatic cavities inside the sella turcica causes deformation of the bone and compression of the hypophysis and its peduncle, often in association with neurological and endocrine symptoms. Over the past four years 22 patients with primary empty sella syndrome were studied at Pisa University's Department of Neurosurgery with particular emphasis on clinical and radiological pictures and hypophyseal function. Pneumocisternography and computerised tomography of the cranium and cavities were used to verify the diagnosis. Radiology showed alterations to the sella turcica in all cases, principally sellar enlargement, doubled sellar floor and erosion of the clinoid processes. Many patients were obese hypertensives with a long history of headaches. Most of the women revealed amenorrhoea, oligomenorrhoea or early menopause. The study of hypothalamus and hypophysis function shows endocrine alterations in almost all cases.

Adolescent↗
PubMed1984

R1 responses of the trigeminofacial reflex in lesions extrinsic to the brain stem.

Isolated or prevalent impairment of the trigeminofacial reflex (tfr) has been described both in pontine lesions and in lesions extrinsic to the brain stem. No satisfactory explanation of this finding in extrinsic lesions has ever been put forward. In a series of patients with lesions outside the brain stem together with selective or prevalent R1 impairment reported here this finding can be explained by the peculiar anatomy of the various nerve fibers in the trigeminal sensory root.

Adult↗
PubMed1984

Relationship between the circulating levels of adenohypophyseal hormones in blood and in cerebrospinal fluid.

Concentrations of prolactin, follicle stimulating hormone, luteinising hormone and growth hormone were measured simultaneously in the serum and cerebrospinal fluid of 57 patients affected by neurologic disease without any pituitary or diencephalic involvement. Prolactin secretion was stimulated in another group of 12 patients using sulpiride or metoclopramide, and the hormone concentration was measured simultaneously in serum and in CSF during the test. Basal studies showed that the concentrations of prolactin, FSH, LH and GH in serum and in CSF were directly correlated (p varying from less than 0.001 to less than 0.05). A negative correlation was found between the molecular weight of hormones reported in this and in other studies and the natural logarithm of the CSF/serum hormone concentration ratios. During prolactin stimulation the correlation between serum and CSF concentration was maintained, nevertheless a higher increase of prolactin in blood than in CSF was observed. This last finding suggests that other mechanisms in addition to filtration from blood into CSF can be responsible for the presence of adenohypophyseal hormones in CSF.

Adolescent↗
PubMed1984

Intrasellar cavernous hemangioma.

We present a very rare case of an intrasellar cavernous hemangioma mimicking, clinically and neuroradiologically, the presence of a nonfunctioning pituitary adenoma. It was possible to diagnose this benign, congenital vascular malformation only through a histological examination.

Adult↗
PubMed1983

Intrasellar metastasis mimicking a pituitary adenoma.

An unusual case of pituitary metastasis from renal cell carcinoma mimicking an adenoma is reported. Panhypopituitarism and chiasmal compression were the first manifestations of the tumor. The clinical, endocrinologic, and pathologic features of pituitary carcinomatous metastasis are discussed.

Adenocarcinoma↗
PubMed1979

Blink reflexes in posterior fossa lesions.

Blink reflexes obtained by electrical stimulation of the supraorbital nerve and electromyographic recording of the orbicularis oculi muscle proved useful as a preliminary method in diagnosis of lesions of the brainstem and the fifth and seventh cranial nerves, and in differentiating intrinsic lesions of the brainstem from extrinsic ones. It was noted that R1 and R2 reflexes were different in the two types of lesions.

Adolescent↗
PubMed1979

Blink reflexes in severe traumatic coma.

Blink reflexes were studied in 21 patients in coma after severe head injury. Our observations suggest that blink reflexes are a simple, objective, neurophysiological test to evaluate brainstem function. Correlations between these reflexes and the anatomoclinical stanges of coma and the Glasgow coma scale have been established. Presence of the early R1 component shows the integrity of at least a part of the pontine structures. The appearance of the late R2 component is correlated with a better chance of recovery from coma.

Acute Disease↗
PubMedDate not supplied

Novel evidence of PLC delta2 involvement in the regulation of the differential evolution of human aneurysms.

The biological and molecular mechanisms which are responsible for the formation and possible evolution of human aneurysms are unknown. Previous investigations have pointed to the possible involvement of inositol specific-phospholipase C (PLC) in the mechanisms related to the formation or evolution of intracranial aneurysms, but, thus far, a relationship of one or more PLC isoforms with the biological signals influencing the fate of this lesion has not been demonstrated. The aim of this study was to investigate the expression, activity and possible modification of PLC isoforms in intracranial aneurysms in patients undergoing elective surgical repair after casual identification of unruptured aneurysms, or during emergency surgical repair of ruptured aneurysms. PLC and proliferating cell nuclear antigen (PCNA) expressions were detected by immunohistochemical analysis; PLC activity was obtained by measuring its hydrolytic activity on labelled PIP(2); PKC activity was measured by total kinase activity assay. Results indicated no substantial differences between controls and aneurysms, with the only exception being PLC delta2 which was nearly absent in controls and ruptured aneurysms, while strongly expressed and functionally active in almost all unruptured aneurysms. In addition, its expression always correlated with the proliferation cell marker PCNA, while its specific activity always correlated to PKC activity. PLC delta2 distribution, regulation and role in human tissues are still unknown Therefore, although preliminary, these data provide a novel insight into the signalling machinery influencing the aneurismal progression.

Adult↗
PubMedDate not supplied

The evaluation of sellar region tumours with pattern visual evoked potentials.

Pattern visual evoked potentials (PVEPs) were performed on 20 patients with sellar tumours. The aim was to assess the validity of full-field PVEPs combined with a topographic recording in chiasmatic compression. They were abnormal in 95% of the patients, with variable patterns (absent or distorted responses). Our results show that PVEPs are very sensitive in revealing compression on visual pathways and that they correlate with the progression of the tumour. However, they are not reliable in detecting the chiasmatic or retrochiasmatic site of the lesion and relative visual field defect, because of the multidirectional extension of the tumour.

Adult↗